Vaginal yeasts in the era of "over the counter" antifungals

Objective: To establish whether then has been any rise in the prevalence of non-albicans Candida species isolated from vaginal swabs since the introdu ction of "over the counter" antifungal treatments. Method: A retrospective review looking at all positive vaginal yeast isolat es collected from women attending one genitourinary medicine clinic during the 6 year period from 1993 to 1998 inclusive. All positive vaginal yeast i solates were included, regardless of whether or not the patients were sympt omatic. Isolates from HIV positive women were excluded from the analysis. Result: No increase in non-albicans vaginal yeast isolates was shown during the period studied. The proportion of non-albicans yeasts remained constan t at approximately 5% of the total yeasts isolated. The most common non-alb icans yeast isolated was C glabrata. Conclusion: There is no evidence from this study to suggest that the increa sing use of "over the counter" antifungal treatment has selected for atypic al, possibly inherently azole resistant, strains of vaginal yeasts in HIV s eronegative women.